Portable jaundice therapy could save infants' lives

Nearly 8 in 10 premature babies, their livers still immature, suffer from jaundice – a build-up of blood pigment that turns their eyes and skin yellow and becomes toxic in the brain. Despite being easily treatable, each year some 6 million babies around the world are left untreated and as a result, are at risk of cerebral palsy, blindness, deafness, cognitive damage and even death.

The problem is that the tried-and-true cure for jaundice – bathing an affected infant in blue light – isn't possible in many hospitals in developing countries, where there is no steady supply of electricity.

Donna Brezinski, a paediatrician based in Boston, may have a solution. She has built a portable, battery-operated device unlike the phototherapy machines that run in modern neonatal intensive care facilities. Her creation – dubbed the "Bili-Hut" – is in the running this month for a $1 million start-up grant from Boston-based MassChallenge.

Reverse engineering

Blue light's 460-nanometre wavelength triggers a chemical reaction that makes the blood pigment bilirubin water-soluble, allowing it to filter out naturally in a baby's urine without liver processing. Standard commercial phototherapy machines do this well, but they cost around $3000 each. They are also bulky, take trained personnel to operate, and require a continuous electrical current.

"This is all about reverse engineering; how to bring the component parts most effectively to the people who need them," Brezinski says. Right now a Bili-Hut costs about $400 per unit, she says, and her team is working to drive production costs down further.

The tent-like structure is about 30 centimetres tall, and arches over a baby like a wagon cover. The hut is held up by 3 fibreglass rods, and can be disassembled and folded into a shipping tube for easy transport.

The interior, lined with the same reflective Mylar material used for thermal blankets, reflects the blue light produced by several embedded LED strips, creating a shine that can run on a 12-volt car battery for up to a month straight. If the light is delivered without interruption, a jaundiced infant can be cured in just a couple of days.

Proof in the pudding

"I think the Bili-Hut has great potential for treatment in the developing world, but there will have to be careful study to make sure the light dose meets professional standards," says Vinod Bhutani, who studies jaundice at Stanford University in California. He adds that the tent design could hinder close supervision of infants, which is crucial during the first week of life. "The safety tests will be critical. The proof is in the pudding," he says.

The first pilot study will start this month at St. Boniface Hospital in Fond-des-Blancs, Haiti, which suffers frequent power outages. Doctors there will be replacing their one standard phototherapy machine with two Bili-Huts.

"We take care of newborns with jaundice daily," said Inobert Pierre, the hospital's director general. "[Electricity] is one of our major concerns right now. Power-hungry equipment puts a heavy toll on our limited system."

Ultimately, Brezinski hopes the Bili-Hut will prove useful in developed countries as well, allowing new mothers to give phototherapy to their babies at home and avoid the high cost of extended hospital stays.

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A working prototype of the Bili-Hut in action (Image: Donna Brezinski)